MEDICARE: JULIE ANNE HIGGINS CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	4704228635	MI

General Provider Information

NPI Number	:	1902828494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANNE HIGGINS CRNA

Provider Business Mailing Address
First Line	:	5209 CLARENDON CREST CT
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-2608
Country	:	US
Telephone Number	:	248-851-7046
Fax Number	:	248-851-3264

Provider Business Practice Location Address
First Line	:	5209 CLARENDON CREST CT
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-2608
Country	:	US
Telephone Number	:	248-851-7046
Fax Number	:	248-851-3264

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	08/09/2009

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